VERSATILE. TREAT SOFT TISSUE, TOOTH ROOT, AND BONE.
REGENERATIVE ER,CR:YSGG PERIODONTITIS REGIMEN
The WaterLase iPlus combines YSGG laser energy and a patented spray of water to cut soft tissue and bone, with reported benefits such as less swelling and postop sensitivity, an optimal patient experience and greater case acceptance.
In soft tissue mode, the laser energy penetrates into tissues to seal blood vessels as it cuts, providing excellent hemostasis, which in turn provides you with a better field of vision during surgery.
THE WATERLASE ®ER,CR:YSGG PERIO REGIMEN is the first definitive step-by-step
protocol for using an Er,Cr:YSGG laser to assist in the management of early, moderate and severe chronic periodontitis. It consists of three phases: pre-surgical, surgical and post-surgical. PRE-OP
PHASE I: PRE-SURGICAL PHASE
PRE-OP
IMMEDIATE POST-OP
All patients should have a comprehensive periodontal examination/evaluation including data collection of periodontal charting and radiographs, medical and dental history, and risk assessment.
IMPLANTS Improve productivity with implant related applications:
OSSEOUS CROWN LENGTHENING FOR SAME DAY REFERRALS
Phase I treatment is implemented for removal of supra- and subgingival biofilm and calculus through scaling and root planing (S/RP) and the initiation and evaluation of oral hygiene compliance. Occlusal assessment and treatment may be warranted in this phase. Splinting of teeth may be an option.
• Creating an aesthetic emergence profile • Bone resection for autogenous bone graft harvesting • Osteoplasty and osteotomy • Implant recovery
Minimize tissue displacement and flap preparation in osseous crown lengthening. It assists in performing an externally beveled gingivectomy, shaping the free gingival margin, troughing, and recontouring or smoothing bone.
PHASE II: SURGICAL PHASE
Phase II surgical treatment plan is developed based on the re-evaluation of periodontal inflammation and oral hygiene compliance. The surgical plan can be for a single tooth or multiple teeth sites, a quadrant or half-mouth depending on number of indicated sites. If desired, the half-mouth protocol is generally UR/LR followed by at least 2-3 weeks of post-operative management before treating the UL/LL areas.
1
POST-OP
OUTER POCKET DE-EPITHELIALIZATION Outer pocket gingival epithelium is removed from the free gingival margin down to a width at least equal to the pocket depth.
INNOVATIVE. SOLVE YOUR POCKET ACCESS CHALLENGES. Pre-set Settings
THE RADIAL FIRING PERIO TIP ™
Tip: RFTP5 Power: 1.5W Air/Water: 40%/50% Pulse rate: 30 Hz H mode
Our patented Radial Firing Perio Tip (RFPT) is superior to traditional laser tips used for periodontal therapy, featuring a unique design that precisely tapers to the tip. The result is primary radial emission of laser energy with a portion of straight emission, and better access to the narrow part of the periodontal pocket. This provides more efficient irradiation of diseased or inflamed soft tissue as well as calculus deposits for treating moderate to advanced periodontal disease.
2
GINGIVECTOMY (AS NEEDED) A gingivectomy should only be performed if pseudo-pocketing is present. Ensure you do not compromise adequate attached gingivae.
Regenerative Er,Cr:YSGG Periodontitis ai Regimen
Tip: RFTP5 Power: 1.5W Air/Water: 40%/50% Pulse rate: 30 Hz H mode
888-424-6527 | www.biolase.com
350-02-001-A
4 Cromwell, Irvine, CA 92618
888-424-6527
www.biolase.com
Effectively manage your periodontal patients with patient-preferred, minimally invasive therapy.
WATERLASE PERIO PROTOCOL ®
Minimally Invasive Protocol for Optimal Periodontal Patient Management
“WaterLase REPai R is a highly effective, more aesthetic and more comfortable alternative to traditional surgical procedures for my patients.” - Dr. Bret Dyer CASE 1
CASE 2
3
Courtesy of Dr. Bret Dyer 8 6 3 3 3 3
3 2 2 2 2
9 8 3 3 3 3
8 3 3 3 3
4 2 2 2 2
10 8 3 3 3 3
6 3 3 3 3
4 2 2 2 2
11 4 3 3 3 3
6 3 3 3 3
4 2 2 2 2
12 3 3 3 3 3
8 3 3 3 3
6 2 2 2 2
13 5 3 3 3 3
5 3 3 3 3
4 2 2 2 2
4 3 3 3 3
BEFORE
REPai R™, Regenerative Er,Cr:YSGG Periodontitis Regimen, was developed to provide clinicians a scientifically advanced treatment option for managing periodontally compromised patients. Utilizing the WaterLase iPlus and patented Radial Firing Perio Tip™ (RFPT), REPai R provides a safe, effective laser treatment protocol that patients accept. Minimally invasive protocol.
Courtesy of Dr. Bret Dyer
3 YEARS AFTER
CASE 3
8
9
10
11
12
Courtesy of Dr. Rana Al-Falaki
5 7 3 3 3 3
6 2 2 2 2 8
6 3 3 3 3
5 3 4 3 3
4 2 2 2 2 9
6 3 3 3 3
6 3 3 3 3
6 2 2 2 2
5 3 3 3 3
6 3 3 3 3
10
6 2 2 2 2 11
5 3 3 3 3
5 3 3 3 3
7 2 2 2 2
5 3 3 3 3
12
7 3 3 3 3
7 2 2 2 2 13
5 3 3 3 3
BEFORE
6 MONTHS AFTER
6
CLINICAL EVIDENCE
Versatile YSGG laser ideal for comprehensive clinical use.
M Gupta, AK Lamba, M Verma, et al. “Comparison of periodontal open flap debridement versus closed debridement with Er,Cr:YSGG laser.” Australian Dental Journal 2013; 58: 41-49 doi: 10.1111/adj.12021
Cleared for gentle removal of subgingival calculus.
Dederich 2013. “Periodontal Bone Regeneration and the Er,Cr:YSGG Laser: A Case Report.” The Open Dentsitry Journa, 2013, 7, 16-19
Promotes cementum-mediated periodontal ligament new-attachment to the root surface in the absence of long junctional epithelium.
Dyer, B, and E C Sung. “Periodontal Treatment using the Er, Cr : YSGG Laser.” Lasers in Surgery and Medicine: 1442. Hakki, Sema S et al. 2010. “Comparison of Er,Cr:YSGG laser and hand instrumentation on the attachment of periodontal ligament fibroblasts to periodontally diseased root surfaces: an in vitro study.” Journal of periodontology 81(8): 1216-25. http://www.ncbi.nlm.nih.gov/pubmed/20476883
DE-EPITHELIALIZATION AND RETRACTION The pocket epithelium should be removed and should be completed apically, down to bone. The gingival margin can be retracted as a mini flap for access.
Tip: RFPT5 Power: 1.5W Air/Water: 40%/50% Pulse rate: 30 Hz H Mode
SCALING AND ROOT PLANING Conventional treatment with ultrasonics and hand instruments to remove root surface accretions and/or calculus and to smooth cementum.
Laser not used
13
Treat site specific or full mouth cases for greater flexibility in treatment planning. Supported by clinical evidence and scientific research.
4
CONTINUED
Kelbauskiene, Solveiga et al. 2011. “One-year clinical results of Er,Cr:YSGG laser application in addition to scaling and root planing in patients with early to moderate periodontitis.” Lasers in medical science 26(4): 445-52. http://www.ncbi.nlm. nih.gov/pubmed/20549280 Kelbauskiene, Solveiga, and Vita Maciulskiene. 2007. “A pilot study of Er,Cr:YSGG laser therapy used as an adjunct to scaling and root planing in patients with early and moderate periodontitis.” Stomatologija / issued by public institution “Odontologijos studija” ... [et al.] 9(1): 21-6. http://www.ncbi. nlm.nih.gov/pubmed/17449974. Ting, Chun-Chan et al. 2007. “Effects of Er,Cr:YSGG laser irradiation on the root surface: morphologic analysis and efficiency of calculus removal.” Journal of periodontology 78(11): 2156-64. http://www.ncbi.nlm.nih.gov/ pubmed/17970683
Arnabat-Domínguez, Josep et al. 2010. “Advantages and esthetic results of erbium, chromium:yttrium-scandiumgallium-garnet laser application in second-stage implant surgery in patients with insufficient gingival attachment: a report of three cases.” Lasers in medical science 25(3): 459-64. http://www.ncbi.nlm.nih.gov/pubmed/19756837 Walsh, Laurence. 2010. “Maximising gingival aesthetics using lasers.” Australasian Dental Practice (August): 48-51. René Franzen, Marcella Esteves-Oliveira, Jörg Meister, Anja Wallerang, Leon Vanweersch, Friedrich Lampert and Norbert Gutknecht “Decontamination of deep dentin by means of erbium, chromium:yttrium-scandium-gallium-garnet laser irradiation” Lasers in Medical Science Volume 24, Number 1, 75-80, DOI: 10.1007/s10103-007-0522-2
7 8
SULCULAR DEBRIDEMENT / DEGRANULATION Remove smear layer created by scaling, along with any residual calculus, and prepare the root surface for reattachment. Remove pocket lining and degranulate to expose bone surface.
BONE DECORTICATION Recontour osseous defects. Hold tip parallel to root surface and gently tap all the way down to and into bone, retracting slightly and repeating all the way around tooth. If necessary, change angle of the laser tip and treat into the walls of infrabony defects.
Tip: RFPT5 Power: 1.5W Air/Water: 40% / 50% Pulse rate: 30 Hz H mode Increase pulse rate to 75 Hz for faster calculus removal. Tip: MZ6 Power: 2.5W Air/Water: 70% / 80% Pulse rate: 30 Hz H mode
FINAL SULCULAR DEBRIDEMENT Remove residual debris and induce blood coagulation.
COMPRESS WITH 2X2
Tip: RFPT5 Power: 1.5W Air/Water: 10% / 10% Pulse rate: 30 Hz H mode
Compress surgical site with wet 2x2 for 3-5 minutes.
PHASE III: POST-SURGICAL PHASE
Scan the QR code for links to clinical articles
• IMMEDIATE POST-OPERATIVE: Brush teeth lightly with soft brush and use mouth rinse to supplement brushing if discomfort exists. • ONE WEEK AFTER LASER TREATMENT: Gently clean between teeth using an interproximal brush dipped in mouthwash. • NO PROBING for at least 3 months, at which time a supragingival scaling is completed. 888-424-6527 | www.biolase.com
VERSATILE. TREAT SOFT TISSUE, TOOTH ROOT, AND BONE.
REGENERATIVE ER,CR:YSGG PERIODONTITIS REGIMEN
The WaterLase iPlus combines YSGG laser energy and a patented spray of water to cut soft tissue and bone, with reported benefits such as less swelling and postop sensitivity, an optimal patient experience and greater case acceptance.
In soft tissue mode, the laser energy penetrates into tissues to seal blood vessels as it cuts, providing excellent hemostasis, which in turn provides you with a better field of vision during surgery.
THE WATERLASE ®ER,CR:YSGG PERIO REGIMEN is the first definitive step-by-step
protocol for using an Er,Cr:YSGG laser to assist in the management of early, moderate and severe chronic periodontitis. It consists of three phases: pre-surgical, surgical and post-surgical. PRE-OP
PHASE I: PRE-SURGICAL PHASE
PRE-OP
IMMEDIATE POST-OP
All patients should have a comprehensive periodontal examination/evaluation including data collection of periodontal charting and radiographs, medical and dental history, and risk assessment.
IMPLANTS Improve productivity with implant related applications:
OSSEOUS CROWN LENGTHENING FOR SAME DAY REFERRALS
Phase I treatment is implemented for removal of supra- and subgingival biofilm and calculus through scaling and root planing (S/RP) and the initiation and evaluation of oral hygiene compliance. Occlusal assessment and treatment may be warranted in this phase. Splinting of teeth may be an option.
• Creating an aesthetic emergence profile • Bone resection for autogenous bone graft harvesting • Osteoplasty and osteotomy • Implant recovery
Minimize tissue displacement and flap preparation in osseous crown lengthening. It assists in performing an externally beveled gingivectomy, shaping the free gingival margin, troughing, and recontouring or smoothing bone.
PHASE II: SURGICAL PHASE
Phase II surgical treatment plan is developed based on the re-evaluation of periodontal inflammation and oral hygiene compliance. The surgical plan can be for a single tooth or multiple teeth sites, a quadrant or half-mouth depending on number of indicated sites. If desired, the half-mouth protocol is generally UR/LR followed by at least 2-3 weeks of post-operative management before treating the UL/LL areas.
1
POST-OP
OUTER POCKET DE-EPITHELIALIZATION Outer pocket gingival epithelium is removed from the free gingival margin down to a width at least equal to the pocket depth.
INNOVATIVE. SOLVE YOUR POCKET ACCESS CHALLENGES. Pre-set Settings
THE RADIAL FIRING PERIO TIP ™
Tip: RFTP5 Power: 1.5W Air/Water: 40%/50% Pulse rate: 30 Hz H mode
Our patented Radial Firing Perio Tip (RFPT) is superior to traditional laser tips used for periodontal therapy, featuring a unique design that precisely tapers to the tip. The result is primary radial emission of laser energy with a portion of straight emission, and better access to the narrow part of the periodontal pocket. This provides more efficient irradiation of diseased or inflamed soft tissue as well as calculus deposits for treating moderate to advanced periodontal disease.
2
GINGIVECTOMY (AS NEEDED) A gingivectomy should only be performed if pseudo-pocketing is present. Ensure you do not compromise adequate attached gingivae.
Regenerative Er,Cr:YSGG Periodontitis ai Regimen
Tip: RFTP5 Power: 1.5W Air/Water: 40%/50% Pulse rate: 30 Hz H mode
888-424-6527 | www.biolase.com
350-02-001-A
4 Cromwell, Irvine, CA 92618
888-424-6527
www.biolase.com
Effectively manage your periodontal patients with patient-preferred, minimally invasive therapy.
WATERLASE PERIO PROTOCOL ®
Minimally Invasive Protocol for Optimal Periodontal Patient Management
“WaterLase REPai R is a highly effective, more aesthetic and more comfortable alternative to traditional surgical procedures for my patients.” - Dr. Bret Dyer CASE 1
CASE 2
3
Courtesy of Dr. Bret Dyer 8 6 3 3 3 3
3 2 2 2 2
9 8 3 3 3 3
8 3 3 3 3
4 2 2 2 2
10 8 3 3 3 3
6 3 3 3 3
4 2 2 2 2
11 4 3 3 3 3
6 3 3 3 3
4 2 2 2 2
12 3 3 3 3 3
8 3 3 3 3
6 2 2 2 2
13 5 3 3 3 3
5 3 3 3 3
4 2 2 2 2
4 3 3 3 3
BEFORE
REPai R™, Regenerative Er,Cr:YSGG Periodontitis Regimen, was developed to provide clinicians a scientifically advanced treatment option for managing periodontally compromised patients. Utilizing the WaterLase iPlus and patented Radial Firing Perio Tip™ (RFPT), REPai R provides a safe, effective laser treatment protocol that patients accept. Minimally invasive protocol.
Courtesy of Dr. Bret Dyer
3 YEARS AFTER
CASE 3
8
7 3 3 3 3
6 2 2 2 2 8
9
6 3 3 3 3
5 3 4 3 3
4 2 2 2 2 9
10
6 3 3 3 3
6 3 3 3 3
6 2 2 2 2
11
5 3 3 3 3
6 3 3 3 3
10
6 2 2 2 2 11
12
5 3 3 3 3
5 3 3 3 3
7 2 2 2 2
Courtesy of Dr. Rana Al-Falaki
5 3 3 3 3
12
7 3 3 3 3
7 2 2 2 2 13
5
5 3 3 3 3
BEFORE
6 MONTHS AFTER
6
CLINICAL EVIDENCE
Versatile YSGG laser ideal for comprehensive clinical use.
M Gupta, AK Lamba, M Verma, et al. “Comparison of periodontal open flap debridement versus closed debridement with Er,Cr:YSGG laser.” Australian Dental Journal 2013; 58: 41-49 doi: 10.1111/adj.12021
Cleared for gentle removal of subgingival calculus.
Dederich 2013. “Periodontal Bone Regeneration and the Er,Cr:YSGG Laser: A Case Report.” The Open Dentsitry Journa, 2013, 7, 16-19
Promotes cementum-mediated periodontal ligament new-attachment to the root surface in the absence of long junctional epithelium.
Dyer, B, and E C Sung. “Periodontal Treatment using the Er, Cr : YSGG Laser.” Lasers in Surgery and Medicine: 1442. Hakki, Sema S et al. 2010. “Comparison of Er,Cr:YSGG laser and hand instrumentation on the attachment of periodontal ligament fibroblasts to periodontally diseased root surfaces: an in vitro study.” Journal of periodontology 81(8): 1216-25. http://www.ncbi.nlm.nih.gov/pubmed/20476883
DE-EPITHELIALIZATION AND RETRACTION The pocket epithelium should be removed and should be completed apically, down to bone. The gingival margin can be retracted as a mini flap for access.
Tip: RFPT5 Power: 1.5W Air/Water: 40%/50% Pulse rate: 30 Hz H Mode
SCALING AND ROOT PLANING Conventional treatment with ultrasonics and hand instruments to remove root surface accretions and/or calculus and to smooth cementum.
Laser not used
13
Treat site specific or full mouth cases for greater flexibility in treatment planning. Supported by clinical evidence and scientific research.
4
CONTINUED
Kelbauskiene, Solveiga et al. 2011. “One-year clinical results of Er,Cr:YSGG laser application in addition to scaling and root planing in patients with early to moderate periodontitis.” Lasers in medical science 26(4): 445-52. http://www.ncbi.nlm. nih.gov/pubmed/20549280 Kelbauskiene, Solveiga, and Vita Maciulskiene. 2007. “A pilot study of Er,Cr:YSGG laser therapy used as an adjunct to scaling and root planing in patients with early and moderate periodontitis.” Stomatologija / issued by public institution “Odontologijos studija” ... [et al.] 9(1): 21-6. http://www.ncbi. nlm.nih.gov/pubmed/17449974. Ting, Chun-Chan et al. 2007. “Effects of Er,Cr:YSGG laser irradiation on the root surface: morphologic analysis and efficiency of calculus removal.” Journal of periodontology 78(11): 2156-64. http://www.ncbi.nlm.nih.gov/ pubmed/17970683
Arnabat-Domínguez, Josep et al. 2010. “Advantages and esthetic results of erbium, chromium:yttrium-scandiumgallium-garnet laser application in second-stage implant surgery in patients with insufficient gingival attachment: a report of three cases.” Lasers in medical science 25(3): 459-64. http://www.ncbi.nlm.nih.gov/pubmed/19756837 Walsh, Laurence. 2010. “Maximising gingival aesthetics using lasers.” Australasian Dental Practice (August): 48-51. René Franzen, Marcella Esteves-Oliveira, Jörg Meister, Anja Wallerang, Leon Vanweersch, Friedrich Lampert and Norbert Gutknecht “Decontamination of deep dentin by means of erbium, chromium:yttrium-scandium-gallium-garnet laser irradiation” Lasers in Medical Science Volume 24, Number 1, 75-80, DOI: 10.1007/s10103-007-0522-2
7 8
SULCULAR DEBRIDEMENT / DEGRANULATION Remove smear layer created by scaling, along with any residual calculus, and prepare the root surface for reattachment. Remove pocket lining and degranulate to expose bone surface.
BONE DECORTICATION Recontour osseous defects. Hold tip parallel to root surface and gently tap all the way down to and into bone, retracting slightly and repeating all the way around tooth. If necessary, change angle of the laser tip and treat into the walls of infrabony defects.
Tip: RFPT5 Power: 1.5W Air/Water: 40% / 50% Pulse rate: 30 Hz H mode Increase pulse rate to 75 Hz for faster calculus removal. Tip: MZ6 Power: 2.5W Air/Water: 70% / 80% Pulse rate: 30 Hz H mode
FINAL SULCULAR DEBRIDEMENT Remove residual debris and induce blood coagulation.
COMPRESS WITH 2X2
Tip: RFPT5 Power: 1.5W Air/Water: 10% / 10% Pulse rate: 30 Hz H mode
Compress surgical site with wet 2x2 for 3-5 minutes.
PHASE III: POST-SURGICAL PHASE
Scan the QR code for links to clinical articles
• IMMEDIATE POST-OPERATIVE: Brush teeth lightly with soft brush and use mouth rinse to supplement brushing if discomfort exists. • ONE WEEK AFTER LASER TREATMENT: Gently clean between teeth using an interproximal brush dipped in mouthwash. • NO PROBING for at least 3 months, at which time a supragingival scaling is completed. 888-424-6527 | www.biolase.com
WATERLASE PERIO PROTOCOL ®
Minimally Invasive Protocol for Optimal Periodontal Patient Management
“WaterLase REPai R is a highly effective, more aesthetic and more comfortable alternative to traditional surgical procedures for my patients.” - Dr. Bret Dyer CASE 1
CASE 2
3
Courtesy of Dr. Bret Dyer 8 6 3 3 3 3
3 2 2 2 2
9 8 3 3 3 3
8 3 3 3 3
4 2 2 2 2
10 8 3 3 3 3
6 3 3 3 3
4 2 2 2 2
11 4 3 3 3 3
6 3 3 3 3
4 2 2 2 2
12 3 3 3 3 3
8 3 3 3 3
6 2 2 2 2
13 5 3 3 3 3
5 3 3 3 3
4 2 2 2 2
4 3 3 3 3
BEFORE
REPai R™, Regenerative Er,Cr:YSGG Periodontitis Regimen, was developed to provide clinicians a scientifically advanced treatment option for managing periodontally compromised patients. Utilizing the WaterLase iPlus and patented Radial Firing Perio Tip™ (RFPT), REPai R provides a safe, effective laser treatment protocol that patients accept. Minimally invasive protocol.
Courtesy of Dr. Bret Dyer
3 YEARS AFTER
CASE 3
8
7 3 3 3 3
6 2 2 2 2 8
9
6 3 3 3 3
5 3 4 3 3
4 2 2 2 2 9
10
6 3 3 3 3
6 3 3 3 3
6 2 2 2 2
11
5 3 3 3 3
6 3 3 3 3
10
6 2 2 2 2 11
12
5 3 3 3 3
5 3 3 3 3
7 2 2 2 2
Courtesy of Dr. Rana Al-Falaki
5 3 3 3 3
12
7 3 3 3 3
7 2 2 2 2 13
5
5 3 3 3 3
BEFORE
6 MONTHS AFTER
6
CLINICAL EVIDENCE
Versatile YSGG laser ideal for comprehensive clinical use.
M Gupta, AK Lamba, M Verma, et al. “Comparison of periodontal open flap debridement versus closed debridement with Er,Cr:YSGG laser.” Australian Dental Journal 2013; 58: 41-49 doi: 10.1111/adj.12021
Cleared for gentle removal of subgingival calculus.
Dederich 2013. “Periodontal Bone Regeneration and the Er,Cr:YSGG Laser: A Case Report.” The Open Dentsitry Journa, 2013, 7, 16-19
Promotes cementum-mediated periodontal ligament new-attachment to the root surface in the absence of long junctional epithelium.
Dyer, B, and E C Sung. “Periodontal Treatment using the Er, Cr : YSGG Laser.” Lasers in Surgery and Medicine: 1442. Hakki, Sema S et al. 2010. “Comparison of Er,Cr:YSGG laser and hand instrumentation on the attachment of periodontal ligament fibroblasts to periodontally diseased root surfaces: an in vitro study.” Journal of periodontology 81(8): 1216-25. http://www.ncbi.nlm.nih.gov/pubmed/20476883
DE-EPITHELIALIZATION AND RETRACTION The pocket epithelium should be removed and should be completed apically, down to bone. The gingival margin can be retracted as a mini flap for access.
Tip: RFPT5 Power: 1.5W Air/Water: 40%/50% Pulse rate: 30 Hz H Mode
SCALING AND ROOT PLANING Conventional treatment with ultrasonics and hand instruments to remove root surface accretions and/or calculus and to smooth cementum.
Laser not used
13
Treat site specific or full mouth cases for greater flexibility in treatment planning. Supported by clinical evidence and scientific research.
4
CONTINUED
Kelbauskiene, Solveiga et al. 2011. “One-year clinical results of Er,Cr:YSGG laser application in addition to scaling and root planing in patients with early to moderate periodontitis.” Lasers in medical science 26(4): 445-52. http://www.ncbi.nlm. nih.gov/pubmed/20549280 Kelbauskiene, Solveiga, and Vita Maciulskiene. 2007. “A pilot study of Er,Cr:YSGG laser therapy used as an adjunct to scaling and root planing in patients with early and moderate periodontitis.” Stomatologija / issued by public institution “Odontologijos studija” ... [et al.] 9(1): 21-6. http://www.ncbi. nlm.nih.gov/pubmed/17449974. Ting, Chun-Chan et al. 2007. “Effects of Er,Cr:YSGG laser irradiation on the root surface: morphologic analysis and efficiency of calculus removal.” Journal of periodontology 78(11): 2156-64. http://www.ncbi.nlm.nih.gov/ pubmed/17970683
Arnabat-Domínguez, Josep et al. 2010. “Advantages and esthetic results of erbium, chromium:yttrium-scandiumgallium-garnet laser application in second-stage implant surgery in patients with insufficient gingival attachment: a report of three cases.” Lasers in medical science 25(3): 459-64. http://www.ncbi.nlm.nih.gov/pubmed/19756837 Walsh, Laurence. 2010. “Maximising gingival aesthetics using lasers.” Australasian Dental Practice (August): 48-51. René Franzen, Marcella Esteves-Oliveira, Jörg Meister, Anja Wallerang, Leon Vanweersch, Friedrich Lampert and Norbert Gutknecht “Decontamination of deep dentin by means of erbium, chromium:yttrium-scandium-gallium-garnet laser irradiation” Lasers in Medical Science Volume 24, Number 1, 75-80, DOI: 10.1007/s10103-007-0522-2
7 8
SULCULAR DEBRIDEMENT / DEGRANULATION Remove smear layer created by scaling, along with any residual calculus, and prepare the root surface for reattachment. Remove pocket lining and degranulate to expose bone surface.
BONE DECORTICATION Recontour osseous defects. Hold tip parallel to root surface and gently tap all the way down to and into bone, retracting slightly and repeating all the way around tooth. If necessary, change angle of the laser tip and treat into the walls of infrabony defects.
Tip: RFPT5 Power: 1.5W Air/Water: 40% / 50% Pulse rate: 30 Hz H mode Increase pulse rate to 75 Hz for faster calculus removal. Tip: MZ6 Power: 2.5W Air/Water: 70% / 80% Pulse rate: 30 Hz H mode
FINAL SULCULAR DEBRIDEMENT Remove residual debris and induce blood coagulation.
COMPRESS WITH 2X2
Tip: RFPT5 Power: 1.5W Air/Water: 10% / 10% Pulse rate: 30 Hz H mode
Compress surgical site with wet 2x2 for 3-5 minutes.
PHASE III: POST-SURGICAL PHASE
Scan the QR code for links to clinical articles
• IMMEDIATE POST-OPERATIVE: Brush teeth lightly with soft brush and use mouth rinse to supplement brushing if discomfort exists. • ONE WEEK AFTER LASER TREATMENT: Gently clean between teeth using an interproximal brush dipped in mouthwash. • NO PROBING for at least 3 months, at which time a supragingival scaling is completed. 888-424-6527 | www.biolase.com
VERSATILE. TREAT SOFT TISSUE, TOOTH ROOT, AND BONE.
REGENERATIVE ER,CR:YSGG PERIODONTITIS REGIMEN
The WaterLase iPlus combines YSGG laser energy and a patented spray of water to cut soft tissue and bone, with reported benefits such as less swelling and postop sensitivity, an optimal patient experience and greater case acceptance.
In soft tissue mode, the laser energy penetrates into tissues to seal blood vessels as it cuts, providing excellent hemostasis, which in turn provides you with a better field of vision during surgery.
THE WATERLASE ®ER,CR:YSGG PERIO REGIMEN is the first definitive step-by-step
protocol for using an Er,Cr:YSGG laser to assist in the management of early, moderate and severe chronic periodontitis. It consists of three phases: pre-surgical, surgical and post-surgical. PRE-OP
PHASE I: PRE-SURGICAL PHASE
PRE-OP
IMMEDIATE POST-OP
All patients should have a comprehensive periodontal examination/evaluation including data collection of periodontal charting and radiographs, medical and dental history, and risk assessment.
IMPLANTS Improve productivity with implant related applications:
OSSEOUS CROWN LENGTHENING FOR SAME DAY REFERRALS
Phase I treatment is implemented for removal of supra- and subgingival biofilm and calculus through scaling and root planing (S/RP) and the initiation and evaluation of oral hygiene compliance. Occlusal assessment and treatment may be warranted in this phase. Splinting of teeth may be an option.
• Creating an aesthetic emergence profile • Bone resection for autogenous bone graft harvesting • Osteoplasty and osteotomy • Implant recovery
Minimize tissue displacement and flap preparation in osseous crown lengthening. It assists in performing an externally beveled gingivectomy, shaping the free gingival margin, troughing, and recontouring or smoothing bone.
PHASE II: SURGICAL PHASE
Phase II surgical treatment plan is developed based on the re-evaluation of periodontal inflammation and oral hygiene compliance. The surgical plan can be for a single tooth or multiple teeth sites, a quadrant or half-mouth depending on number of indicated sites. If desired, the half-mouth protocol is generally UR/LR followed by at least 2-3 weeks of post-operative management before treating the UL/LL areas.
1
POST-OP
OUTER POCKET DE-EPITHELIALIZATION Outer pocket gingival epithelium is removed from the free gingival margin down to a width at least equal to the pocket depth.
INNOVATIVE. SOLVE YOUR POCKET ACCESS CHALLENGES. Pre-set Settings
THE RADIAL FIRING PERIO TIP ™
Tip: RFTP5 Power: 1.5W Air/Water: 40%/50% Pulse rate: 30 Hz H mode
Our patented Radial Firing Perio Tip (RFPT) is superior to traditional laser tips used for periodontal therapy, featuring a unique design that precisely tapers to the tip. The result is primary radial emission of laser energy with a portion of straight emission, and better access to the narrow part of the periodontal pocket. This provides more efficient irradiation of diseased or inflamed soft tissue as well as calculus deposits for treating moderate to advanced periodontal disease.
2
GINGIVECTOMY (AS NEEDED) A gingivectomy should only be performed if pseudo-pocketing is present. Ensure you do not compromise adequate attached gingivae.
Regenerative Er,Cr:YSGG Periodontitis ai Regimen
Tip: RFTP5 Power: 1.5W Air/Water: 40%/50% Pulse rate: 30 Hz H mode
888-424-6527 | www.biolase.com
350-02-001-A
4 Cromwell, Irvine, CA 92618
888-424-6527
www.biolase.com
Effectively manage your periodontal patients with patient-preferred, minimally invasive therapy.
